Olmesartan,Other Antihypertensives,and Chronic Diarrhea Among Patients Undergoing Endoscopic Procedures: A Case-Control Study |
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| Institution: | 1. Department of Medicine, Celiac Disease Center, Columbia University College of Physicians and Surgeons, New York, NY;2. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY;1. Resident in Internal Medicine, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN;2. Fellow in Endocrinology, Mayo School of Graduate Medical Education, Mayo Clinic, Rochester, MN;3. Adviser to resident and fellow and Consultant in Pediatric Endocrinology and Metabolism, Mayo Clinic, Rochester, MN;1. Department of Dermatology, Georgetown University Hospital/Washington Hospital Center, Washington, DC;2. Dermatology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD;1. Department of Dermatology, Taipei Medical University Hospital, Taipei, Taiwan;2. Department of Dermatology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan;3. Department of Dermatology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan;1. Department of Radiology, Memorial Sloan Kettering Cancer Center, New York, New York;2. Department of Radiology, Hospital Sírio-Libaneês, Universidade de São Paulo, Dr. Enéas de Carvalho Aguiar, São Paulo, Brazil;3. Department of Radiology, Universidade de São Paulo, Dr. Enéas de Carvalho Aguiar, São Paulo, Brazil;4. Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York;2. Department of Pathology, PGIMER, Chandigarh, India;3. Department of General Surgery, PGIMER, Chandigarh, India |
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| Abstract: | ObjectiveTo investigate a recent association between the use of the angiotensin receptor-blocker (ARB) olmesartan and a severe enteropathy resembling celiac disease.Patients and MethodsWe searched our endoscopy database for all outpatient esophagogastroduodenoscopy (EGD) or colonoscopy examinations in patients aged at least 50 years during the period January 1, 2007, to March 31, 2013. Cases were those whose examination indication was diarrhea, and controls were those whose examination indication was esophageal reflux (EGD) or colorectal cancer screening (colonoscopy). We compared cases with controls with regard to the proportion of those listing olmesartan among their medications. Secondary exposures were the proportion of those taking nonolmesartan ARBs or other antihypertensive medications. We also examined biopsy results to determine whether there were histologic changes associated with the use of olmesartan.ResultsWe identified 2088 patients undergoing EGD and 12,428 patients undergoing colonoscopy meeting inclusion criteria. On multivariate analysis, there was no statistically significant association between olmesartan and diarrhea among those undergoing EGD (odds ratio, 1.99; 95% CI, 0.79-5.00) or colonoscopy (odds ratio, 0.63; 95% CI, 0.23-1.74). Review of pathology reports of the EGD and colonoscopy groups showed no association between the use of olmesartan and the histologic diagnosis of celiac disease (P=.61) or microscopic colitis (P=1.0), respectively.ConclusionOur findings suggest that neither olmesartan nor other ARBs were associated with diarrhea among patients undergoing endoscopy. The spruelike enteropathy recently associated with olmesartan is likely a rare adverse effect and milder presentations are unlikely. |
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| Keywords: | ARB"} {"#name":"keyword" "$":{"id":"kwrd0015"} "$$":[{"#name":"text" "_":"angiotensin receptor-blocker EGD"} {"#name":"keyword" "$":{"id":"kwrd0025"} "$$":[{"#name":"text" "_":"esophagogastroduodenoscopy OR"} {"#name":"keyword" "$":{"id":"kwrd0035"} "$$":[{"#name":"text" "_":"odds ratio |
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